SynthesisBMJ (Clinical research ed.)2023
Fracture risk reduction and safety by osteoporosis treatment compared with placebo or active comparator in postmenopausal women: systematic review, network meta-analysis, and meta-regression analysis of randomised clinical trials.
Synthesis in BMJ (Clinical research ed.), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 113 papers, 12 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
113 citing papers in PubMed, 12 syntheses or guidelines pooled it, 180 citations in OpenAlex.
- Effects of kaempferol on bone loss in animal models of osteoporosis: a systematic review and meta-analysis.Frontiers in endocrinology · 2026Pooled it
- Cardiovascular adverse events associated with epidermal growth factor receptor tyrosine kinase inhibitors inBMJ (Clinical research ed.) · 2025Pooled it
- Effectiveness of anabolic and anti-resorptive agents for preventing postmenopausal osteoporosis fractures: a systematic review and network meta-analysis.Journal of orthopaedic surgery and research · 2025Pooled it
- Management of Osteoporosis in Parkinson's Disease: A Systematic Review of Clinical Practice Guidelines.Movement disorders clinical practice · 2025Pooled it
- Romosozumab adverse event profile: a pharmacovigilance analysis based on the FDA Adverse Event Reporting System (FAERS) from 2019 to 2023.Aging clinical and experimental research · 2025Pooled it
- Effects of anti-osteoporotic drugs in patients with chronic kidney disease: a systemic review and network meta-analysis of bone mineral density, clinical fracture rate and renal function.Frontiers in pharmacology · 2025Pooled it
- Effect of serum MMP-7 on the diagnostic accuracy of biliary atresia: systematic review and meta-analysis.Frontiers in pharmacology · 2025Pooled it
- A bibliometric analysis of acupuncture applied to primary osteoporosis.Frontiers in medicine · 2025Pooled it
- Assessment of the efficacy and safety of anti-sclerostin antibody therapy for osteoporosis in postmenopausal women: a systematic review and meta-analysis of randomized controlled trials.Frontiers in endocrinology · 2025Pooled it
- Brazilian Guideline on Menopausal Cardiovascular Health - 2024.Arquivos brasileiros de cardiologia · 2024Guideline
- Denosumab vs. bisphosphonates in primary osteoporosis: a meta-analysis of comparative safety in randomized controlled trials.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2024Pooled it
- Pooled it
- Randomized crossover comparison of two teriparatide self-injection regimens for primary osteoporosis: final report of the Japanese Osteoporosis Intervention Trial 06 (JOINT-06).Journal of bone and mineral metabolism · 2025Trial
- Effectiveness of treatment initiation for secondary fracture prevention in the older population: Japanese Bone-fracture Osteoporosis in Late-stage population Database study (J-BOLD) - emulation of a randomized target trial.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025Trial
- Therapeutic efficacy of zoledronic acid combined with calcium and calcitriol in the treatment of senile osteoporosis in elderly patients.Inflammopharmacology · 2025Trial
- Trial
- Romosozumab followed by denosumab versus denosumab only: a post hoc analysis of FRAME and FRAME extension.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2024Trial
- Targeting the gut-bone axis in osteoporosis: probiotic interventions and other microbiota-based therapeutic strategies.Gut microbes · 2026Review
- Modern pharmacological management of Osteoporosis: from monotherapy to sequential and combination approaches in postmenopausal women.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Review
- Effectiveness and Safety of Pharmacological Therapy for Osteoporosis in Frail Elderly Individuals: Systematic Review and Meta-Analysis.Health science reports · 2026Review
53 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
22 authors at 13 institutions in 9 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo review the comparative effectiveness of osteoporosis treatments, including the bone anabolic agents, abaloparatide and romosozumab, on reducing the risk of fractures in postmenopausal women, and to characterise the effect of antiosteoporosis drug treatments on the risk of fractures according to baseline risk factors.
designSystematic review, network meta-analysis, and meta-regression analysis of randomised clinical trials. DATA SOURCES: Medline, Embase, and Cochrane Library to identify randomised controlled trials published between 1 January 1996 and 24 November 2021 that examined the effect of bisphosphonates, denosumab, selective oestrogen receptor modulators, parathyroid hormone receptor agonists, and romosozumab compared with placebo or active comparator. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Randomised controlled trials that included non-Asian postmenopausal women with no restriction on age, when interventions looked at bone quality in a broad perspective. The primary outcome was clinical fractures. Secondary outcomes were vertebral, non-vertebral, hip, and major osteoporotic fractures, all cause mortality, adverse events, and serious cardiovascular adverse events.
resultsThe results were based on 69 trials (>80 000 patients). For clinical fractures, synthesis of the results showed a protective effect of bisphosphonates, parathyroid hormone receptor agonists, and romosozumab compared with placebo. Compared with parathyroid hormone receptor agonists, bisphosphonates were less effective in reducing clinical fractures (odds ratio 1.49, 95% confidence interval 1.12 to 2.00). Compared with parathyroid hormone receptor agonists and romosozumab, denosumab was less effective in reducing clinical fractures (odds ratio 1.85, 1.18 to 2.92 for denosumab
conclusionsThe evidence indicated a benefit of a range of treatments for osteoporosis in postmenopausal women for clinical and vertebral fractures. Bone anabolic treatments were more effective than bisphosphonates in the prevention of clinical and vertebral fractures, irrespective of baseline risk indicators. Hence this analysis provided no clinical evidence for restricting the use of anabolic treatment to patients with a very high risk of fractures. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019128391.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.